Consensus on Medical Nutrition Therapy for Diabesity (CoMeND) in Adults: A South Asian Perspective

Abstract

Diabetes and obesity are both increasing at a fast pace and giving rise to a new epidemic called diabesity. Lifestyle interventions including diet play a major role in the treatment of diabetes, obesity and diabesity. There are many guidelines on dietary management of diabetes or obesity globally and also from South Asia. However, there are no global or South Asian guidelines on the non-pharmacological management of diabesity. South Asia differs from the rest of the world as South Asians have different phenotype, cooking practices, food resources and exposure, medical nutrition therapy (MNT) practices, and availability of trained specialists. Therefore, South Asia needs its own guidelines for nonpharmacological management of diabesity in adults. The aim of the Consensus on Medical Nutrition Therapy for Diabesity (CoMeND) in Adults: A South Asian Perspective is to recommend therapeutic and preventive MNT in the South-Asians with diabesity.

Trabecular Bone Score and Bone Mineral Density in Postmenopausal Women with Morbid Obesity—A Clinical Paradox

“…Eighty-five subjects with morbid obesity (BMI ≥ 35 kg/m 2 ) were recruited from the multidisciplinary obesity clinic in the hospital, and they were compared to 80 subjects with obesity (BMI ≥ 25–35 kg/m 2 ) and 85 non-obese women (BMI ≤ 25 kg/m 2 ) recruited from the community. The BMI cut-off points for obesity were defined as per the Asia-Pacific guidelines by the WHO, which suggest lower thresholds for obesity to identify the higher at-risk individuals at a lower BMI [ 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 ]. This study was approved by the Institutional Review Board (IRB Min no.…”

South Asian Working Action Group on SARCOpenia (SWAG-SARCO) – A consensus document

“…South Asian countries are mostly low middle income countries and face resource and cost challenges [ 70 ]. The guidance should be appropriate for the local healthcare delivery system, which places greater reliance on clinical medicine than investigations.…”

“…Overnutrition results in metabolic challenges as discussed earlier and sarcopenic obesity [ 37 , 38 ]. South Asians are increasingly leading a sedentary life style, and the region is seeing an increase in lifestyle and economic growth related non-communicable diseases in middle-aged and elderly which likely to increase secondary sarcopenia burden in this region [ 67 , 68 , [70] , [71] , [72] ].…”

“…Primordial prevention is aimed at preventing the development of risk factors for sarcopenia. This includes maintaining dietary diversity and protein intake as per recommended dietary allowance (RDA) (1–1.2 g/kg) [ 70 , 122 ]. It also includes encouraging South Asian physical activity practices 123 such as using oriental style of toilets (squatting), sitting on the floor cross-egged for doing day to day activities, and non-mechanized ways of carrying out activities of daily living such as washing clothes with hands, using bucket and mug to bathe, squatting to mop floors, and grinding using stone grinder.…”

Quantifying Remission Probability in Type 2 Diabetes Mellitus

“…It is important to note that MNT is not the same as diabetes self-management training and also may require ethnicity-specific adjustments. [ 26 , 34 ]. The effectiveness of MNT in T2DM was demonstrated by the Diabetes Remission Clinical Trial (DiRECT), which showed that weight loss associated with lifestyle intervention caused diabetes remission in 46% of study participants after one year.…”